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Diabetic Retinopathy May Predict Heart Failure

Posted: Wednesday, April 23, 2008

Diabetic retinopathy appears to be an independent risk factor for heart failure, new research suggests, which supports the belief that microvascular disease plays a role in the development of heart failure in diabetics. 

As reported in the Journal of the American College of Cardiology for April 22, Dr. Tien Y. Wong from the University of Melbourne in Australia and colleagues analyzed data from 1021 adults with type 2 diabetes who were free from renal and heart disease at baseline.

Overall, 125 (12.8%) of the subjects had diabetic retinopathy at baseline. During 9 years of follow-up, 106 patients (10.1%) developed heart failure, the investigators note.

The cumulative incidence of heart failure in subjects with retinopathy was 21.6%, significantly higher than the 8.5% seen in those without retinopathy. After adjusting for several demographic features and for glycemic control, carotid disease, and endothelial dysfunction, the hazard ratio for heart failure associated with diabetic retinopathy was 2.20.
Editorialists Dr. Hector O. Ventura and Dr. Madhavi Reddy, from the Ochsner Clinic Foundation in New Orleans, comment that the current findings could have important implications for clinicians.

"Current guidelines already identify the need for routine screening for retinopathy in the diabetic patient. In addition to appropriate vision care, the detection of retinopathy might now also warrant a fuller cardiac evaluation and closer follow-up to prevent the development of heart failure," they state.

Source: Diabetes In Control: J Am Coll Cardiol 2008;51:1573-1580.

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